- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,924.54 / $18,506.30 / $24,162.60
| Facility | | $8,924.54 | $18,506.30 | $24,162.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,681.75 / $45,254.97
| Facility | | $5,840.42 | $16,681.75 | $45,254.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,456.67 / $17,290.32 / $26,125.88
| Facility | | $10,456.67 | $17,290.32 | $26,125.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,554.04 / $24,554.04 / $24,554.04
| Facility | | $24,554.04 | $24,554.04 | $24,554.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,066.01 / $17,418.43 / $26,898.17
| Facility | | $15,066.01 | $17,418.43 | $26,898.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,681.75 / $45,254.97
| Facility | | $5,840.42 | $16,681.75 | $45,254.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,143.02 / $35,367.16
| Facility | | $5,840.42 | $13,143.02 | $35,367.16 |